COSO Map Template Documenting Internal Control Evaluations The COSO Framework sets out five Components of internal control and seventeen Principles representing the fundamental concepts associated with Components. These Components and Principles of internal control are suitable for all entities and groups of people. All seventeen Principles also apply to each Category of Objective, as well as to objectives and sub-objectives within a Category. Additionally, the Control Activities Component of control represents the actions established by policies and procedures to help ensure that management directives carried out. These Control Activities are performed at all levels of the entity and extend down into the organization to the business processes and transactional level, and over the technology environment. Documentation of internal controls can be done using two tools, the COSO Template (for entitylevel controls) and the Risk Control Matrix (for activity-level controls). This is depicted below. Larry Hubbard © 2014 03 Page 1 COSO Map Template COSO Map Template (For Documenting Entity-Level Controls) Internal or Control Environment (5 principles) - the CE is the set of standards, processes, and structures that provide the basis for carrying out internal control across the organization. The board of directors and senior management establish the tone at the top regarding the importance of internal control and expected standards of conduct. Principle Control Mechanisms CE1 Integrity and Ethical Values. The organization demonstrates a commitment to integrity and ethical values (Codes of conduct, mission and values statements, procedures to determine and deal with ethical compliance, conflict of interest committees) CE2 Independent BOD. The board demonstrates independence from management and exercises oversight of the development and performance of internal control. (Frequency of challenges to management, interactions with auditors and management, direction given to external auditors, level of independence, clarity of charters and levels of expertise needed, role in whistle-blowing procedures, reviews of financial information, clarity of governance processes, oversight of internal control) CE3 Roles and Responsibilities. Management establishes, with board oversight, structures, reporting lines, and appropriate authorities and responsibilities in the pursuit of objectives. (Organization charts showing reporting lines, project teams, quality circles, focus groups, committee structures, organizational design functions, limits of authority, approval processes, controls over management overrides, delegations of authority, accountability mechanisms, responsibility matrices such as RACI charts) CE4 Commitment to Competence. The organization demonstrates a commitment to attract, develop, and retain competent individuals in alignment with objectives. (Analysis of skills required for jobs, job descriptions, training and development efforts, professional development programs, mentoring and coaching programs, succession planning, employment contracts, evaluating outsourced providers) CE5 Accountabilities. The organization holds individuals accountable for their internal control responsibilities in the pursuit of objectives. (Organization-wide human resource policies and standards, hiring and selection procedures, employee termination procedures, salary and bonus systems Larry Hubbard © 2014 03 Page 2 COSO Map Template based on performance measures, background checks, personnel evaluation systems, upward and 360 feedback processes, employee self-assessment processes, remedial actions for poor work, alignment of risks and rewards) ERM-IE6 COSO ERM Added: Risk management philosophy, appetite, culture and tolerance Risk Assessment - Objectives, Risks, and Responses (4 principles) – Risk assessment involves a dynamic and iterative process for identifying and analyzing risks to achieving the entity’s objectives, forming a basis for determining how risks should be managed. Management considers possible changes in the external environment and within its own business model that may impede its ability to achieve its objectives. RA6 Objective Setting. The organization specifies objectives with sufficient clarity to enable the identification and assessment of risks relating to objectives. (Strategic and directional objectives; SMART objectives; prioritization of objectives; alignment of mission statements, vision statements, and objectives; sub-unit and departmental and process-level objectives.) RA7 Risk Identification and Assessment. The organization identifies risks to the achievement of its objectives across the entity and analyzes risks as a basis for determining how the risks should be managed. (Surveys, discussions and meetings with appropriate personnel to identify risk events; estimating severity of potential risks; procedures to consider what could go wrong at entity- and activity- and process-levels; management making decisions to accept, avoid, reduce or share risks based on cost, benefit, impact and likelihood) RA8 Fraud Risks. The organization considers the potential for fraud in assessing risks to the achievement of objectives. (Fraud committee activities, identification of risks due to: asset misappropriations, corruption, fraudulent statements; fraud workshops; fraud prevention programs; assessing opportunities and incentives) RA9 Impact of Changes. The organization identifies and assesses changes that could significantly impact the system of internal control. (Mechanisms, discussions and meetings to identify risks due to changes in external conditions, business model, and leadership; impact of business process changes) ERM-RA10 Added: Distinguishing risks and opportunities and a portfolio view of risks. Larry Hubbard © 2014 03 Page 3 COSO Map Template Note: Management making decisions to accept, avoid, reduce or share risks based on cost, benefit, impact and likelihood is part of internal control, but the actions undertaken to share or reduce the significance or likelihood of a risk (that is, risk responses) are part of the management process, not an element of internal control. In COSO ERM these are identified as the risk responses component. Control Activities (3 principles) – CA’s are the actions established by policies and procedures to help ensure that management directives to mitigate risks to the achievement of objectives are carried out. CA’s are performed at all levels of the entity and at various stages within business processes, and over the technology environment. Note: Control Activities are the most voluminous Component of internal control (in terms of control mechanisms). They extend from the entity-levels down to the business process and transactional levels for all parts of the organization, and relate to all operational, reporting and compliance objectives. Generally, first understanding the entity-level control mechanisms in the other four Components of control will prepare for an evaluation of the control mechanisms in place for the Control Activities Component (a top-down approach.) Alternatively, a bottom-up approach, where Control Activities are evaluated before the entity-level Components are understood, may lead to duplication of work in identifying the controls in place to mitigate risks. CA10 Selection of Control Activities to Address Risks. The organization selects and develops CA’s that contribute to the mitigation of risks to the achievement of objectives to acceptable levels. Integrated with Risk Assessment at transaction-processing and higher levels. (Reconciliations; physical safeguarding and access controls; comparisons and counts; matching of documents; supervisory approvals; transaction and credit limits, business process and transactional controls to ensure completion, accuracy, validity; segregation of incompatible duties; manual and automated controls over how transactions are initiated, authorized, recorded, processed and reported; controls over period-end financial reporting; tests of disaster recovery plans; formal document retention schedules; Controls specific to certain industries: Federal Acquisition Regulations; Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards; national and regional accreditation for universities) Most of the mechanisms to carry out these CA’s will exist within the business activities (including business and transactional processing systems) across the organization and are unique to those activities. Thus, they cannot all be listed here. An activity-level risk and control matrix can be used for each activity. (See end of document) CA11 General Controls over Technology. The organization selects and develops general controls activities over technology to support the achievement of objectives. (IT infrastructure, general and application controls; program development and change controls; access controls to programs and data; computer operations controls; acquisition, Larry Hubbard © 2014 03 Page 4 COSO Map Template development and maintenance processes; tests of IT contingency plans; passwords and user identifiers and privileges; areas defined in COBIT and Global Technology Audit Guide (GTAG) control models) CA12 Deploys through Policies and Procedures. The organization deploys control activities through policies that establish what is expected and procedures that put policies into action. (Procedure manuals, desk manuals, instruction books; help screens; annual and long-term budgeting procedures; standardized contracts; chart of accounts structures; procedures for analytical analyses such as relating operating and financial data; procedures for organization-wide reviews and monitoring of budgets; earnings meetings and reviews of operating results; disclosure committee activities; reviews of public reports by management, other reviews of organization functions, operations, or procedures; reviews of policies for continued relevance) Note: some management initiatives are full-scale methodologies designed to achieve business objectives. Examples of these initiatives are shown below as control activities, but in practice they supply controls to all the COSO components. If present in an organizational unit, their activities and controls can be mapped to the relevant COSO components to provide a consistent framework for an evaluation of control across the whole organization. Other-CA Some management and quality initiatives are entity-wide methodologies designed to help achieve business objectives. For instance ISO 9000, 10000, 14000, 31000 certifications; Malcolm Baldrige quality programs; Total Quality Management efforts; Balanced Scorecard systems, Enterprise Risk Management; compliance with Sarbanes-Oxley and Basel Accords; Management by Objectives; Six Sigma programs; Occupational Health, Safety and Environment programs; Learning Organizations; Key Performance Indicators (KPI) and Key Success Factor (KSF) programs; security, legal and regulatory compliance functions. Information and Communication (3 principles) – Information is necessary for the entity to carry out internal control responsibilities in support of achievement of its objectives. Communication occurs both internally and externally and provides the organization with the information needed to carry out day-to-day controls. Communication enables personnel to understand internal control responsibilities and their importance to the achievement of objectives. Larry Hubbard © 2014 03 Page 5 COSO Map Template IC13 Gathering and Using Relevant Information. The organization obtains or generates and uses relevant, quality information to support the functioning of internal control. (Surveys to gauge knowledge of code of conduct, clarity of objectives, other information about Principles of control; using suggestion boxes, discussion boards, intranet websites, customer websites, and portals to obtain information; market share reports, competitor analysis; other companies earnings releases, annual reports, 10K’s; monitoring social websites for information; ERP systems, EDI information exchange systems, information data bases, and other methods to process information and be sure it is accurate) IC14 Internal Communications. The organization internally communicates information, including objectives and responsibilities for internal control, necessary to support the functioning of internal control. (Personnel announcements; internal newsletters; formal policy and procedure systems; management guides; scheduled management presentations; open forum meetings, all hands and departmental meetings; video and telephone message broadcasts; executive lunches with employees; separate lines of communication; management messages about security, ethics, citizenship, policies, risks, controls, policies, objectives, strategies, values; Board of Director meetings; metrics, balanced scorecards, dashboards) IC15 External Communications. The organization communicates with external parties regarding matters affecting the function of internal control. (Customer forums; external surveys; analyst meetings; external websites, publications and newsletters; hotlines; independent assessment of outsourced providers; independent auditors reports; results of regulatory reviews and audits; postings on social media websites and company website; accreditation reviews; OSHA reviews; examiners) App-IC Most business areas depend on an underlying IT application for daily or routine transaction processing. Such applications help manage the transactional volume, and their controls are considered in CA10 and CA11. Monitoring Activities (2 principles) – Ongoing evaluations, separate evaluations or some combination of the two are used to ascertain whether each of the five components of internal control, including controls to effect the Principles within each component, is present and functioning. Findings are evaluated and deficiencies are communicated in a timely manner, with serious matters reported to senior management and to the board. Larry Hubbard © 2014 03 Page 6 COSO Map Template Note: Monitoring in COSO relates to assessing the operation of internal control and risk management processes, as opposed to Control Activities such as top-level reviews, forecasts and budgets which are entity-wide control activities. MA16 Ongoing and Separate Evaluations of Components. The organization selects, develops, and performs ongoing and/or separate evaluations to ascertain whether the components of internal control are present and functioning. (Asking questions while walking around; discussing Principles of controls with employees; talking with customers about employee conduct; supervisor observations; periodic reviews by internal auditors, quality auditors, and specialists; internal security reviews; reviewing maturity models and key performance indicators over time for changes; benchmarking studies; self-assessments; understanding the monitoring performed by out-sourced service providers and its impact on internal controls) MA17 Reporting of Deficiencies in Control. The organization evaluates and communicates internal control deficiencies in a timely manner to those parties responsible for taking corrective action, including senior management and the board of directors, as appropriate. (Distributing reports on evaluations to senior management and the Board; follow-up on control gaps and problems that occur; open issues lists; status reporting on audit and other reviews and studies; fraud reporting and investigation mechanisms) The above was accumulated from Internal Control - Integrated Framework (2013) and Enterprise Risk Management (ERM) - Integrated Framework (2004). Larry Hubbard © 2014 03 Page 7 COSO Map Template Activity-Level Risk/Control Matrix (For Documenting Control Activities Component of Control) Control Activities are the most voluminous Component of internal control (in terms of control mechanisms). They extend from the entity-levels down to the business process and transactional levels for all parts of the organization, and relate to all operational, reporting and compliance objectives. Generally, first understanding the entity-level control mechanisms in the other four Components of control will prepare for an evaluation of the control mechanisms in place for the Control Activities Component (a top-down approach.) Alternatively, a bottom-up approach, where Control Activities are evaluated before the entity-level Components are understood, may lead to duplication of work in identifying the controls in place to mitigate risks. Larry Hubbard © 2014 03 Page 8